The following post was written by my inspirational friend, Michelle Howie. She wants to share her breastfeeding story as a means of providing information, encouragement and hope to other mothers who may be struggling with a low milk supply. Thank you, Michelle.
My name is Michelle and I have low milk supply.
Like someone sitting at an AA meeting, I feel now like I want to share my story with you. Now is the right time as my second son, Willis, reaches nearly 15 months and I have some space to look back and marvel at our journey. He is exclusively breastfed and always has been - but that statement innocently glosses over seven months of supplementing with donated EBM and many moments of doubt, exhaustion and fear. How did you manage that? Why did that happen? The answers are elusive even to me, but here's a bit of the story so far.
My breastfeeding life began in April 2011 when Beren, my eldest son was born, at home. To summarise what is not a short story at all, we first discovered I had low milk supply in his first week and he was mix-fed from that point until five and a half months when I switched to formula only. My midwife observed a depressed fontanelle and dry tongue four days after birth and when I agreed to give him 20ml of formula in a syringe, he finally rested for what felt like the first time. Scrambling her networks, my midwife sourced him donated breast milk from amazing generous, sometimes faceless women in our town. My amazing husband drove all over town daily, picking up fresh milk and handing back washed containers. At six weeks, we switched to formula top ups only, from a bottle. I pumped relentlessly, took every herbal everything I could try, domperidone and saw a lactation consultant. In hindsight, I was a mess, mentally. I know that my mental state has a lot to do with my milk supply - now. Then, as now, La Leche League became a huge source of support and friendship for our family. A place I could crumble and grieve, but still be a part of something special even as I became the only mother there using formula in a bottle.
Two years and one month later, Willis was born, also at home. I saw a lactation consultant ante-natally who saw no reason to assume I would experience the same low supply issues. I expressed tiny droplets of colostrum for him from 35 weeks, about 5ml was collected before he was born at 42 weeks. I dreamt of the other breastfeeding challenges I might get to experience...maybe I'll get a cracked nipple! Mastitis might be interesting, I wonder if I will get it this time?
He was born so gently in the birthing pool, such a powerful labour brought forth such a sweet boy. I felt it could be different and sure enough, he was keen to feed soon after birth, latched on like a professional and fed till he slept in my arms. I wept with joy. It felt so so good, I cannot tell you. But low and behold, day five heralded the conversations about topping up with EBM. I knew the signs, I scrutinised every nappy so closely, wanting to see urine not urates. I listened so closely every time he fed, was that a swallow? I think it was...but there just wasn't enough there in those early days. We used my expressed colostrum, then some more from a friend who gave birth around the same time. Day six I started domperidone, I saw the lactation consultant again who 'didn't want to discuss low supply until day 10'. But I knew what we were dealing with, intuitively.
Now don't be too sad! This story gets better, I promise. My post-natal notes talk about keeping the faith, about tears of grief and hugs between a sad mum and her caring midwife. Well, we did keep the faith and something beautiful happened over time...here's how.
In retrospect, when I became a mother and first learnt about low supply I made two decisions: to feed my boys all the milk I made; and also to try to increase my milk production through any and all means possible. Even my best efforts at both of these decisions has needed me to choose a supplementing option both times I birthed a healthy baby. I chose homebirth, for lots of beautiful reasons and I have experienced two incredible, natural, unmedicated births. There was no retained placenta, no trauma - no reason we could point out to explain why my milk didn't come in. I do make milk, just not very much and it doesn't arrive in a big gush after my babies are born. I don't have PCOS, there are no family patterns that explain this. It's a head scratcher, what can I say. It's a giant pain in the ....!!
So, Willis was about a week old and I was feeling sad but resolved to make this work. I posted on the milk sharing pages on Facebook on day eight and started picking up milk locally. This time there seemed to be lots available - or maybe this time, I really wanted it and wasn't too shy to ask. What was different? I knew so much more - I had sleepily read books borrowed from La Leche League and followed articles and posts online about low supply. I can tell you about flow preference and nipple confusion. I had made some great informed choices about what I wanted to achieve with supplementing this time, to try and delay or even not need to use bottles and formula at all. My memories of the grief and stress I felt mix feeding Beren are not pretty. I wanted to stay in a better place, mentally and be happier with my decisions. I felt lots of apprehension as well, knowing that I had found lactaids so fiddly with Beren and that it could be hard to learn how to latch and supplement at the breast successfully. How was I going to get the hang of it all and look after a cheeky toddler too? Would Willis cooperate?
Well, it seemed that Willis read the memo on how to be a star supplemented baby! He accepted EBM however it was presented - little tube on a syringe, then feeding tube dropped into a little pot. Supplementing at the breast seemed to be so much easier this time, I didn't find it as fiddly as I had feared. He was doing great; gaining, weeing, pooing. My midwife and I monitored his gain carefully to strike the right balance between topping him up and filling him up. The goal was to maximise stimulation at the breast and not make it too easy for him to guzzle EBM. This was hard, but we soon learnt he was a boob-fiend and there was little danger of him preferring anything else. As he grew and wriggled, the pot of precious EBM balanced precariously on my bra didn't cut it and I followed a youtube video to make my own supplementary nursing system. I liked mine way better than the Medela one I tried and it meant I could go out and feed him without too much fuss.
It wasn't all perky happiness, let me be honest. I did my fair share of pillow-bashing, wailing 'why me? this is SO unfair! why can't I just make enough milk for my child?'. But each time I indulged the sobbing and sat up all bleary, there was still a dirty house filled with hungry boys waiting for me. So I just got up and got on with things. That has been a huge life lesson for me, to just get on with something because nothing was ever fixed from waiting and wishing.
Another difference was my firm decision to not express milk through a pump for Willis. I just could not see how this would fit into family life and I wanted to just feed, feed, feed instead of pump. This was also something that paid dividends for us - it definitely gave Willis every opportunity at the breast and created a very strong attachment to breastfeeding that may prove hard to end! I knew that every time he fed, he would be sending my body the right signals to make more milk - so I fed him all the time. I conquered the art of feeding him in a woven sling, then in a mei tai, then a buckle carrier as he grew. I fed him at the park, walking to playcentre, in the shops - whenever he fussed or whenever I wanted him to. It was subtle and I had two hands free for Beren. At home, we sat down to feed lots, which was a welcome rest on busy days. Beren was a sweet brother and often sat with us feeding his baby too.
We started to hit our stride and Willis was thriving as a supplemented baby. At about 4 months he started to notice mealtimes and he was trying foods a few weeks later. This was a lot earlier than Beren and a lot earlier than I had planned, but I just let him show us what he wanted. He was very coordinated in his mouth, with good swallowing and took food in so readily. I was quite amazed. I started to realise that if he ate well he might reduce his need for EBM. This was the start of the end of EBM. We hit another chapter when he managed to drop night top ups and could 'cope' with just mum's milk overnight. As he ate more, we used less EBM. My requests on the Facebook pages slowed down and we had to cycle our frozen stores carefully to make sure we used the oldest milk first.
This is a good point to talk about the incredible milk sharing networks in our country. I was so lucky to never run out of EBM - and man, I used a lot! At hard times, in the dark early hours with a hungry baby, I grounded myself with the thought of all those pumping mamas out there, giving their gift to me and my baby so freely. Women are incredibly generous in the milk sharing community and it is a real option for all families that I would encourage people to research further.
Around October, we planned our new year's summer holiday and booked a campsite. I wondered, hmm, how will this work? You know what? We jumped off the cliff in January and Willis managed to fly without EBM for our 7 day trip. By February, we had stopped looking back and the EBM journey seemed distant. Ahh, sweet bliss, we had done it! We all felt so glad we had persevered. When I say 'we', I really mean a family effort. I have had the unfailing support and love of my husband, friends and family for this journey. I don't think I could have put in the effort myself if I wasn't so encouraged and valued by people that I care about. The 'village' made this possible.
Some of this philosophy of 'feed the baby, always' has stuck hard. I feed Willis to sleep, I feed him back to sleep if he stirs, if he cries I feed him - we feed, feed, feed. Over a year into this adventure I have to confess I am pretty tired. He is a restless sleeper and feeds a lot in the night. However, when I imagine not feeding him, or the protest if I try to wean him at MY pace, I feel even more exhausted! There have been some recent low points, mainly because of fatigue. I have totally considered weaning him. I stopped taking domperidone in March to let the natural end of my supply begin. Nothing has changed! Willis is aware, as a smart 14 month old boy, that mum doesn't always have a drink there for him, but he feeds for comfort anyway. I know that there are swallows...sometimes...but I realise it's more than milk for him. It's a place he has spent a lot of his life and it represents mum, softness and 'ours'. I enjoy feeding him as he grows older too - recently he pulled off, sat up and clapped delightedly, gave me a hug then carried on his feed. It's exquisite to make him this happy.
Feeding Willis nourishes my sense of self, it is a boost to my esteem and I draw on that feeling of success at other times. We really have triumphed over low supply. Why would I want to end that before I have really basked in the glow?!
Reflections? LOTS! The two biggest are; that support is golden, I found friends and organisations that had what I needed and I let myself be lifted by their kaupapa; and that the journey to being a mother has revealed strength and grit that I didn't know I possessed. I happily take on the really hard stuff now - I wonder, what is your secret mother super-power?!